Five ways for hospitals to tackle winter pressure

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An effective infection prevention and control programme and antimicrobial stewardship will significantly help in winter pressure. Important highlights worthy of mentioning are:

• During winter there is the challenge of the annual recurrence of Norovirus diarrhoea and vomiting affecting both the community and hospital settings. Some inpatients will inevitably manifest with diarrhoea alone or in addition vomiting whether acquired in the community or the hospital. Consequently beds, bays or wards will be closed, which will have a direct impact on bed capacity, patient flow and potential cancellation of elective surgery. Further repercussions include breach of the four hour wait target in Accident and Emergency.

• As a result of increase in winter related infections, mainly chest infections, there will be a proportionate increase in antimicrobial prescribing, which leads to increase in incidence of Clostridium difficile infections and increase in length of stay and isolation facilities occupancy.

• Older patients who are not discharged in a timely planned manner may develop hospital acquired lower respiratory tract infections with further exposure to antimicrobials and higher risk of developing Clostridium difficile infections with its adverse effects on winter pressures.

In managing the winter pressure situation, we need to follow the same principle as managing infections which is: prevention is better than cure.